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Daniels RF, Schaffner SF, Dieye Y, Dieng G, Hainsworth M, Fall FB, Diouf CN, Ndiop M, Cisse M, Gueye AB, Sarr O, Guinot P, Deme AB, Bei AK, Sy M, Thwing J, MacInnis B, Earle D, Guinovart C, Sene D, Hartl DL, Ndiaye D, Steketee RW, Wirth DF, Volkman SK. Genetic evidence for imported malaria and local transmission in Richard Toll, Senegal. Malar J 2020; 19:276. [PMID: 32746830 PMCID: PMC7397603 DOI: 10.1186/s12936-020-03346-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/25/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Malaria elimination efforts can be undermined by imported malaria infections. Imported infections are classified based on travel history. METHODS A genetic strategy was applied to better understand the contribution of imported infections and to test for local transmission in the very low prevalence region of Richard Toll, Senegal. RESULTS Genetic relatedness analysis, based upon molecular barcode genotyping data derived from diagnostic material, provided evidence for both imported infections and ongoing local transmission in Richard Toll. Evidence for imported malaria included finding that a large proportion of Richard Toll parasites were genetically related to parasites from Thiès, Senegal, a region of moderate transmission with extensive available genotyping data. Evidence for ongoing local transmission included finding parasites of identical genotype that persisted across multiple transmission seasons as well as enrichment of highly related infections within the households of non-travellers compared to travellers. CONCLUSIONS These data indicate that, while a large number of infections may have been imported, there remains ongoing local malaria transmission in Richard Toll. These proof-of-concept findings underscore the value of genetic data to identify parasite relatedness and patterns of transmission to inform optimal intervention selection and placement.
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Affiliation(s)
- Rachel F. Daniels
- grid.38142.3c000000041936754XHarvard T.H. Chan School of Public Health, Boston, MA USA ,grid.66859.34Broad Institute, Cambridge, MA USA
| | | | | | | | | | - Fatou B. Fall
- Senegal National Malaria Control Programme, Dakar, Senegal
| | | | - Medoune Ndiop
- Senegal National Malaria Control Programme, Dakar, Senegal
| | | | | | - Oumar Sarr
- Senegal National Malaria Control Programme, Dakar, Senegal
| | | | - Awa B. Deme
- Dantec Teaching and Research Hospital, Dakar, Senegal
| | - Amy K. Bei
- grid.38142.3c000000041936754XHarvard T.H. Chan School of Public Health, Boston, MA USA
| | - Mouhamad Sy
- Dantec Teaching and Research Hospital, Dakar, Senegal
| | - Julie Thwing
- grid.416738.f0000 0001 2163 0069Centers for Disease Control and Prevention, Atlanta, GA USA
| | | | | | | | - Doudou Sene
- Senegal National Malaria Control Programme, Dakar, Senegal
| | - Daniel L. Hartl
- grid.38142.3c000000041936754XHarvard University, Cambridge, MA USA
| | - Daouda Ndiaye
- grid.8191.10000 0001 2186 9619Cheikh Anta Diop University, Dakar, Senegal
| | | | - Dyann F. Wirth
- grid.38142.3c000000041936754XHarvard T.H. Chan School of Public Health, Boston, MA USA ,grid.66859.34Broad Institute, Cambridge, MA USA
| | - Sarah K. Volkman
- grid.38142.3c000000041936754XHarvard T.H. Chan School of Public Health, Boston, MA USA ,grid.66859.34Broad Institute, Cambridge, MA USA ,grid.28203.3b0000 0004 0378 6053Simmons University, Boston, MA USA
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Tine RC, Sylla K, Faye BT, Poirot E, Fall FB, Sow D, Wang D, Ndiaye M, Ndiaye JL, Faye B, Greenwood B, Gaye O, Milligan P. Safety and Efficacy of Adding a Single Low Dose of Primaquine to the Treatment of Adult Patients With Plasmodium falciparum Malaria in Senegal, to Reduce Gametocyte Carriage: A Randomized Controlled Trial. Clin Infect Dis 2018; 65:535-543. [PMID: 28605472 PMCID: PMC5848230 DOI: 10.1093/cid/cix355] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 04/25/2017] [Indexed: 12/30/2022] Open
Abstract
Introduction More information is needed about the safety of low-dose primaquine in populations where G6PD deficiency is common. Methods Adults with Plasmodium falciparum malaria were randomized to receive 1 of 3 artemisinin combination therapies (ACTs) with or without primaquine (0.25 mg/kg). Glucose-6-phosphate dehydrogenase (G6PD) status was determined using a rapid test. Patients were followed for 28 days to record hemoglobin concentration, adverse events, and gametocyte carriage. The primary end point was the change in Hb at day 7. Results In sum, 274 patients were randomized, 139 received an ACT alone, and 135 received an ACT + primaquine. The mean reduction in Hb at day 7 was similar in each group, a difference in the ACT + PQ versus the ACT alone group of −0.04 g/dL (95% confidence interval [CI] −0.23, 0.31), but the effect of primaquine differed according to G6PD status. In G6PD-deficient patients the drop in Hb was 0.63 g/dL (95% CI 0.03, 1.24) greater in those who received primaquine than in those who received an ACT alone. In G6PD-normal patients, the reduction in Hb was 0.22 g/dL (95% CI −0.08, 0.52) less in those who received primaquine (interaction P = .01). One G6PD normal patient who received primaquine developed moderately severe anaemia (Hb < 8 g/dL). Dark urine was more frequent in patients who received primaquine. Primaquine was associated with a 73% (95% CI 24–90) reduction in gametocyte carriage (P = .013). Conclusion Primaquine substantially reduced gametocyte carriage. However, the fall in Hb concentration at day 7 was greater in G6PD-deficient patients who received primaquine than in those who did not and one patient who received primaquine developed moderately severe anemia. Clinical Trial registration PACTR201411000937373 (www.pactr.org)
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Affiliation(s)
- Roger C Tine
- Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal
| | - Khadime Sylla
- Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal
| | - Babacar T Faye
- Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal
| | - Eugenie Poirot
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco
| | - Fatou B Fall
- National Malaria Control Programme, Ministère de la Santé et de l'Action sociale, Dakar, Senegal
| | - Doudou Sow
- Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal
| | - Duolao Wang
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Magatte Ndiaye
- Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal
| | - Jean Louis Ndiaye
- Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal
| | - Babacar Faye
- Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal
| | - Brian Greenwood
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Oumar Gaye
- Department of Medical Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal
| | - Paul Milligan
- Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Daniels RF, Deme AB, Gomis JF, Dieye B, Durfee K, Thwing JI, Fall FB, Ba M, Ndiop M, Badiane AS, Ndiaye YD, Wirth DF, Volkman SK, Ndiaye D. Evidence of non-Plasmodium falciparum malaria infection in Kédougou, Sénégal. Malar J 2017; 16:9. [PMID: 28049489 PMCID: PMC5209815 DOI: 10.1186/s12936-016-1661-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 12/16/2016] [Indexed: 11/10/2022] Open
Abstract
Background Expanded malaria control efforts in Sénégal have resulted in increased use of rapid diagnostic tests (RDT) to identify the primary disease-causing Plasmodium species, Plasmodium falciparum. However, the type of RDT utilized in Sénégal does not detect other malaria-causing species such as Plasmodium ovale spp., Plasmodium malariae, or Plasmodium vivax. Consequently, there is a lack of information about the frequency and types of malaria infections occurring in Sénégal. This study set out to better determine whether species other than P. falciparum were evident among patients evaluated for possible malaria infection in Kédougou, Sénégal. Methods Real-time polymerase chain reaction speciation assays for P. vivax, P. ovale spp., and P. malariae were developed and validated by sequencing and DNA extracted from 475 Plasmodium falciparum-specific HRP2-based RDT collected between 2013 and 2014 from a facility-based sample of symptomatic patients from two health clinics in Kédougou, a hyper-endemic region in southeastern Sénégal, were analysed. Results Plasmodium malariae (n = 3) and P. ovale wallikeri (n = 2) were observed as co-infections with P. falciparum among patients with positive RDT results (n = 187), including one patient positive for all three species. Among 288 negative RDT samples, samples positive for P. falciparum (n = 24), P. ovale curtisi (n = 3), P. ovale wallikeri (n = 1), and P. malariae (n = 3) were identified, corresponding to a non-falciparum positivity rate of 2.5%. Conclusions These findings emphasize the limitations of the RDT used for malaria diagnosis and demonstrate that non-P. falciparum malaria infections occur in Sénégal. Current RDT used for routine clinical diagnosis do not necessarily provide an accurate reflection of malaria transmission in Kédougou, Sénégal, and more sensitive and specific methods are required for diagnosis and patient care, as well as surveillance and elimination activities. These findings have implications for other malaria endemic settings where species besides P. falciparum may be transmitted and overlooked by control or elimination activities. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1661-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rachel F Daniels
- Department of Immunology and Infectious Disease, Harvard T.H. Chan School of Public Health, Boston, MA, USA. .,Infectious Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| | - Awa Bineta Deme
- Department of Parasitology and Mycology, Cheikh Anta Diop University, Dakar, Senegal
| | - Jules F Gomis
- Department of Parasitology and Mycology, Cheikh Anta Diop University, Dakar, Senegal.,Laboratory of Parasitology and Mycology, Cheikh Anta Diop University/Le Dantec Hospital, Dakar, Senegal.,Malaria Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Baba Dieye
- Department of Parasitology and Mycology, Cheikh Anta Diop University, Dakar, Senegal
| | - Katelyn Durfee
- Department of Immunology and Infectious Disease, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Julie I Thwing
- Malaria Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.,President's Malaria Initiative, Dakar, Senegal
| | - Fatou B Fall
- National Malaria Control Programme, Dakar, Senegal
| | - Mady Ba
- National Malaria Control Programme, Dakar, Senegal
| | | | - Aida S Badiane
- Department of Parasitology and Mycology, Cheikh Anta Diop University, Dakar, Senegal.,Laboratory of Parasitology and Mycology, Cheikh Anta Diop University/Le Dantec Hospital, Dakar, Senegal.,Malaria Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Dyann F Wirth
- Department of Immunology and Infectious Disease, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Infectious Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Sarah K Volkman
- Department of Immunology and Infectious Disease, Harvard T.H. Chan School of Public Health, Boston, MA, USA. .,Infectious Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA. .,School of Nursing and Health Sciences, Simmons College, Boston, MA, USA.
| | - Daouda Ndiaye
- Department of Parasitology and Mycology, Cheikh Anta Diop University, Dakar, Senegal.,Laboratory of Parasitology and Mycology, Cheikh Anta Diop University/Le Dantec Hospital, Dakar, Senegal.,Malaria Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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NDiaye JL, Cissé B, Ba EH, Gomis JF, Ndour CT, Molez JF, Fall FB, Sokhna C, Faye B, Kouevijdin E, Niane FK, Cairns M, Trape JF, Rogier C, Gaye O, Greenwood BM, Milligan PJM. Correction: Safety of Seasonal Malaria Chemoprevention (SMC) with Sulfadoxine-Pyrimethamine plus Amodiaquine when Delivered to Children under 10 Years of Age by District Health Services in Senegal: Results from a Stepped-Wedge Cluster Randomized Trial. PLoS One 2016; 11:e0168421. [PMID: 27930741 PMCID: PMC5145224 DOI: 10.1371/journal.pone.0168421] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0162563.].
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Thiam S, Thwing J, Diallo I, Fall FB, Diouf MB, Perry R, Ndiop M, Diouf ML, Cisse MM, Diaw MM, Thior M. Scale-up of home-based management of malaria based on rapid diagnostic tests and artemisinin-based combination therapy in a resource-poor country: results in Senegal. Malar J 2012; 11:334. [PMID: 23009244 PMCID: PMC3507725 DOI: 10.1186/1475-2875-11-334] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 09/06/2012] [Indexed: 11/10/2022] Open
Abstract
Background Effective case management of malaria requires prompt diagnosis and treatment within 24 hours. Home-based management of malaria (HMM) improves access to treatment for populations with limited access to health facilities. In Senegal, an HMM pilot study in 2008 demonstrated the feasibility of integrated use of RDTs and ACT in remote villages by volunteer Home Care Providers (HCP). Scale-up of the strategy began in 2009, reaching 408 villages in 2009 and 861 villages in 2010. This paper reports the results of the scale-up in the targeted communities and the impact of the strategy on malaria in the formal health sector. Methods Data reported by the HCPs were used to assess their performance in 2009 and 2010, while routine malaria morbidity and mortality data were used to assess the impact of the HMM programme. Two high transmission regions where HMM was not implemented until 2010 were used as a comparison. Results and discussion From July 2009 through May 2010, 12582 suspected cases were managed by HCPs, 93% (11672) of whom were tested with an RDT. Among those tested, 37% (4270) had a positive RDT, 97% (4126) of whom were reported treated and cured. Home care providers referred 6871 patients to health posts for management: 6486 with a negative RDT, 119 infants < 2 months, 105 pregnant women, and 161 severe cases. There were no deaths among these patients. In 2009 compared to 2008, incidence of suspected and confirmed malaria cases, all hospitalizations and malaria-related hospitalizations decreased in both intervention and comparison regions. Incidence of in-hospital deaths due to malaria decreased by 62.5% (95% CI 43.8-81.2) in the intervention regions, while the decrease in comparison regions was smaller and not statistically significant. Conclusion Home-based management of malaria including diagnosis with RDT and treatment based on test results is a promising strategy to improve the access of remote populations to prompt and effective management of uncomplicated malaria and to decrease mortality due to malaria. When scaled-up to serve remote village communities in the regions of Senegal with the highest malaria prevalence, home care providers demonstrated excellent adherence to guidelines, potentially contributing to a decrease in hospital deaths attributed to malaria.
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Affiliation(s)
- Sylla Thiam
- African Medical and Research Foundation, Nairobi, Kenya
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